Approved Referral Sample Clauses
An Approved Referral clause defines the conditions under which one party may refer potential clients, customers, or business opportunities to another party with the receiving party's prior consent. Typically, this clause outlines the process for obtaining approval for each referral, specifies any criteria that must be met for a referral to be considered valid, and may address compensation or obligations arising from successful referrals. Its core practical function is to ensure that referrals are subject to oversight and meet agreed standards, thereby protecting the interests of both parties and preventing unauthorized or inappropriate referrals.
Approved Referral. An Approved Referral constitutes an authorized service under the VA CCN Requirements (as defined below). Approved Referrals will support a specific plan of care as it relates to a specified number or visits and/or services approved for the individual Enrolled Eligible Veteran over a specified period of time not to exceed one (1) year.
Approved Referral. A communication (oral, written, or electronic) sent by a PCP or other Participating Provider that specifies the health services to be rendered by another Provider identified in such communication and approved by the WHP Health Services Department (HSD) or WHP Medical Director. This approval is not a guarantee that WHP will Cover the requested health service or item because of other provisions in this Agreement. Exhibits, Eligibility, Exclusions, Limitations, Coordination of Benefits, the Benefit Summary and any applicable Riders also control whether a requested health service or item will be Covered by WHP.
Approved Referral. A VA Approved Referral constitutes an authorized service under the VA CCN Requirements (as defined below). Approved Referrals from VA will support a specific plan of care provided by a specified provider identified by National Provider Identifier (NPI) or provider organization identified by Tax Identifier Number (TIN). The Approved Referral relates to a specified number of visits and/or services related to a Standard Episode of Care, and the approved services must be rendered within the specified timeframe. This process requires that an Approved Referral be provided “prior to” rendering the specified service.